Objective: To investigate the use of sensors and Internet of things (IoT) devices in older adult care via literature review.

Methods: We researched the literature published until 2021 based on Ichu-shi Web, CiNii, MEDLINE, CINAHL, and CNKI. Accordingly, we extracted the data pertaining to the purpose, positive, and negative aspects of the use of developed sensors and IoT devices in older adult care. The sensors and IoT devices were classified according to the intended use described in the adopted literature.

Results: 26 studies were adopted. Sensors and IoT devices were classified into the following 11 types according to the intended use or purpose: for calculating and evaluating the amount of physical activity, preventing getting off the bed and falling, ensuring safety, estimating work position and location change, evaluating sleep state, 24-h vital sign monitoring, reducing the discomfort caused owing to wearing diapers, quantifying the amount of urine retained in the bladder, detecting laughter and facilitating communication, monitoring the facility living environment, and improving and reinforcing care services.

Conclusion: The details of the sensor and IoT device use extracted through the literature review will serve as a reference when widely introducing the devices in long-term care facilities in the future.

Objective: To clarify the concept of self-management of menstrual symptoms in working women and examine the usefulness of concept utilization in nursing intervention.

Method: The concept analysis method described by Rodgers & Knafl (2000).

Results: The following four attributes were identified: “Acquisition and utilization of literacy regarding menstrual-related symptoms and coping behavior”, “Step-by-step behavior change for problem solving”, “Utilization of workplace resources” and “Maintaining efforts in working life”. In addition, four antecedents and three consequences were identified.

Conclusion: This concept was “activities for working women to address issues through proactive and strategic management using health literacy and workplace resources in order to improve their menstrual symptoms and obstacles to work and life. The process by which a person’s problem coping behavior is refined”. In addition, it was suggested that it could be used as a basis for nursing support to promote self-management for a group of working women.

Objective: To clarify the practices of visiting nurses regarding partnerships with parents in pediatric home care settings through a review of qualitative literature and to obtain suggestions for nursing care.

Methods: Original qualitative research articles reporting the partnerships between parents and visiting nurses in pediatric home care were searched on the following databases: PubMed, CINAHL, and the Ichu-shi Web. Data on nursing practices related to partnerships with parents was extracted from the included articles, and content analysis was performed.

Results: Nine articles were included in this review. Through the analysis, the following themes were extracted: “practices of visiting nurses who can always empower parents,” “practices of visiting nurses from the perspective of a tripartite relationship working for the best of the child,” and “practices of visiting nurses who try to build optimal relationships with parents.”

Conclusion: Visiting nurses supported the parent’s feelings, sought the best for the child, and adjusted the relationship over time. This review suggests the importance of building a relationship with the parents based on an understanding of these characteristics. Therefore, to achieve the best relationship with parents, identifying what visiting nurses are doing to partner with parents and developing a scale to assess and educate visiting nurses about partnership practices are imperative.

Objective: The purpose of this study was to analyze the concept of “priority” in clinical nursing and clarify its definition.

Methods: A total of 47 papers were analyzed using Rodgers’s (2000) concept analysis approach.

Results: The following three attributes were extracted: [estimated from the impact on life], [weighted by the patient’s condition], and [variable depending on the situation]. In addition, four antecedents were extracted: [responsibilities both as a nurse and member of the organization], [differences in nurse’ proficiency], [influence of organizational culture and systems], and [time constraints and lack of staff]. Finally, three consequents were extracted: [work is performed efficiently], [work is adjusted in order], and [dilemma arises in care delivery].

Conclusion: “Priority” in clinical nursing was defined as “The positioning of nursing practice in which the impact on life is estimated, weighted according to the patient’s condition to determine their relative importance, and fluctuates according to the situation.”

Aims: We aimed to clarify the definition of self-management during conservative treatment in patients with HOA.

Methods: The Walker and Avant’s method of concept analysis was performed on 43 articles.

Results: The following were extracted as attributes of self-management during conservative treatment in patients with HOA: self-determination and acceptance of disease, acquisition of knowledge and skills for treating and coping with problems, refining how to deal with a problem, negative emotional management, adjusting social roles, using resources and information, and cooperation with medical professionals. The antecedents to self-management were personal health issues and perceptions , and influences exerted by the social environment. The consequences of self-management were change to a healthy lifestyle, improving locomotor function, acceptance of HOA and changes to positive emotions, improved self-efficacy, and maintenance and improvement of QOL.

Conclusion: We defined this concept as “it is a process in which patients, in collaboration with medical professionals, actively participate in their own treatment and make regular, intentional, and continuous efforts toward goals aligned with their individual needs by utilizing their own abilities. Patients acquire knowledge about HOA and its treatment, take responsibility for healthy behaviors, and independently refine coping methods while learning skills to manage the disease, their emotions, and their social roles.”

Purpose: To conduct a conceptual analysis of, and provide a definition for, the recovery of family members in codependent relationships with people with addiction problems.

Methods: We analyzed 41 references using Rogers’ method.

Results: The seven attributes included: “connecting to support which suits oneself and finding a place to belong;” “understanding and accepting addiction and codependence;” “changing the way one is involved without taking on responsibility for the person concerned;” “practicing self-care to protect one’s inner self;” “maintaining an appropriate psychological distance from the person concerned;” “communicating trust and affirmation and rebuilding family relationships;” and “affirming one’s new self and new life.” Eight antecedent requirements and two consequences were extracted—including: “Improved family function, in which the recovery process of the family and the person interact” and “the establishment of new self-esteem.”

Conclusion: We defined that, while family members were connected to the support that suited them, and had a place in their hearts, they were respected as adults and maintained an appropriate psychological distance while working on the self-care needed to face their inner selves and in affirming their new selves and live again.

Objective: To clarify the structure of self-regulated learning in clinical practice through conceptual analysis.

Method: Rodgers’s evolutionary concept analysis was applied to 42 literature sources.

Results: The attributes were sorted into nine categories. One of them was a “three-stage cyclic process,” which showed structure. The learning process was characterized by the following: “situation analysis to achieve the task,” “goal setting and strategic planning,” “resourceful use of learning opportunities,” “performing a wide variety of learning strategies focusing on patient care,” “refining goals through reflection on goal achievement status,” and “recognition of professional identity.” The support for the learning process included “metacognitive and motivational regulation of learning processes” and “engaging others in one’s own learning.” Four prerequisites and three consequences were identified.

Conclusion: The definition of this concept is a cyclic and continuous learning process that resourcefully uses learning opportunities in clinical practice, performing a wide variety of learning strategies to pursue goal attainment, and is driven by Metacognition, motivation, and interaction with others. The potential for application in clinical settings has been demonstrated.

Purpose: The purpose of this study was to examine the correlation between life experiences and resilience including timeframes of people living with life-threatening diseases and disabilities, to gather suggestions for nursing practice and research through a comprehensive review of the literature.

Method: A comprehensive review of the literature was conducted. Articles were searched using the Igaku Chuo Zassi, PubMed, CINAHL, and PsycInfo databases to extract appropriate results and organize the content from the review.

Results: Eighteen studies were extracted. Living with a serious disease and disability entailed a course of recovery that follows periods of disintegration and despair while including resilience over time. Resilience was the process or ability to recover from difficulties; it had direct and indirect positive relationships with physical and psychosocial outcomes. Resources and related factors that fostered resilience included cultivating good relationships with others, self-efficacy, and social participation.

Conclusion: Psychological intervention approaches for acquiring resilience in relation to recovery and positive outcomes on life experiences, including timeframes, have been proposed. Prospects for further research have been presented.

Objective: This study aimed to analyze the literature on the use of photo elicitation in children and adolescents with chronic diseases and identify the benefits derived from using this method and considerations for its implementation.

Methods: A scoping review was conducted according to the JBI Manual for Evidence Synthesis. Databases of CINAHL, PubMed, CiNii, and Ichushi Web were searched for relevant studies.

Results: Nine studies were extracted, and photo elicitation was used to understand and gain knowledge about the experiences of children living with chronic diseases. Its advantages included stimulating and clarifying children’s memories. Among the nine studies, seven used the method in which the child took the images. In this method, the researcher explained the contents of the image, number of images, and precautions to observe when taking images.

Conclusion: Photo elicitation is a useful research method; however, portrait rights and privacy must be protected.

Aims: The aim of this study was to clarify the structure of “nurse self-sacrifice” and examine the concept’s applicability in nursing practice.

Methods: The study utilized Rodgers & Knafl’ (2000) approach for concept analysis and analyzed 33 references obtained from five databases.

Results: Based on the analysis, three attributes of nurse self-sacrifice were identified, namely prioritizing the patient’s over one’s own interests, exhibiting behavior that positively values being a nurse, and working oneself to the bone. Additionally, four antecedents and three consequences were extracted.

Conclusions: Nurse self-sacrifice was defined as a behavior that prioritizes the patient’s interests over one’s own interests based on positively value as a nurse. A better understanding of nurse self-sacrifice can help differentiate it from altruism and prompt a reevaluation of self-sacrifice in the workplace. This can also facilitate changes in organizational culture that can jeopardize workers’ physical and mental health.

Objective: This study aimed to clarify the concept and structure of compassion fatigue in nurses based on the relevant Japanese and English literature.

Methods: Twelve Japanese and ten English papers were reviewed using Walker and Avant’s concept analysis approach.

Results: Five attributes, seven antecedents, and five consequences were extracted. Compassion fatigue in nurses was defined as “a state in which nurses are continuously involved empathically with patients and their families in distress and pain for a long period of time, and experience feelings of helplessness and guilt associated with ethical conflicts, physical and mental illness, decreased empathy, deep fatigue, and low self-esteem when they cannot find meaning in nursing, leading to decreased quality of care, leaving the job, etc.”

Conclusion: Compassion is an essential element for nurses, but it is also a risk. The results of this study suggest that nurses need to be aware of the risk of compassion, acquire knowledge of compassion fatigue, and consider countermeasures.

Purpose: This study aims to identify the nursing competencies required in supporting female victims of sexual violence who visit obstetrics and gynecology clinics immediately after the occurrence.

Methods: Semi-structured interviews were conducted with a total of 21 female victims of sexual violence, nurses with support experience, obstetricians and gynecologists, and support staff. The interview data were analyzed qualitatively and descriptively.

Results: Nursing competencies required in caring for female victims of sexual violence feeling their own security seriously threatened were based on ‘preparation as a supporter’, and included the following skills: ‘responding to protect the safety and security of victims’, ‘forensic assessment and care for victims’, and ‘providing support with a view to the recovery of victims’. Nurses were also required to have the competence to take ‘measures to support themselves’ as self-care and self-improvement to support victims.

Conclusions: The aim of the required nursing competencies was to acquire specialized knowledge and skills related to dealing with sexual violence, and to practice victim-centered support while paying attention to the effects of trauma. The findings suggest that these nursing skills enable nurses to support the recovery of victims.

Purpose: The aim of the study is to examine issues recognized by older adults as important for increasing their degree of well-being.

Methods: A survey was conducted for 1,440 males and females aged 65 years and older who were selected by stratified random sampling (age and gender) from two municipalities that agreed to participate in the study. An anonymous, self-administered questionnaire was sent to the subjects by mail. Among the 796 respondents (response rate: 55.3%), questionnaires were analyzed for 524 subjects who responded to open-ended questions. The responses to these questions on issues that are important for increasing well-being were analyzed using quantitative text analysis.

Results: A morphological analysis resulted in extraction of 1,299 words, which were then classified into 10 themes. Using hierarchical cluster analysis, the 10 themes were classified into three clusters: live a healthy and affluent life, interact with people, and enjoy activities with positive thinking.

Conclusions: The results indicate that, in addition to ensuring income for making a living, the well-being of older adults can be increased by providing support services for maintaining health and interacting with people.

Objective: To clarify sexuality-related experiences among adolescent and young adult (AYA) cancer survivors.

Method: Semi-structured interviews were conducted with 5 men and 6 women aged 18–39 years who had survived cancer as AYA, and the collected data were analyzed qualitatively and descriptively.

Results: Both men and women experienced “concerns regarding sex and having children by themselves”. Men experienced “loss of confidence in being accepted as a man”, which undermined their identity and led to a “fear of the negative impact their potential inability to reproduce would have on their partner’s future”. Women showed “defensiveness toward their partner’s response to changes in their physical appearance and aftereffects of their illness”, but ultimately, they “reevaluated their relationship with their partner and the importance of having children with an understanding of their potential inability to reproduce”.

Conclusion: AYA cancer survivors experience concerns about sex and having children, and have their identities undermined, but still seek a way to live their lives and have relationships with their partners going forward, including the idea of having children.

Objective: We aimed to establish best practices for certified wound, ostomy, and continence nurses (CNs) who design home stoma care programs for older patients with colostomies. We also recommend best practices for general nurses who primarily provide patient care immediately after colostomy surgery.

Methods: Semi-structured interviews were conducted with 12 CNs. Their responses were analyzed using a modified grounded theory approach (M-GTA).

Results: The nursing practice process includes “identifying the practitioner,” “promoting the image of living with a colostomy,” “selecting a brace to match the practitioner,” and “further demonstration of one’s true potential”. Nursing practice was stimulated by a “never seek perfection” attitude.

Conclusion: The “never seek perfection” attitude was thought to be rooted in the nurses’ comprehensive understanding of the “difficulties of living” of older patients who require new self-care. It was suggested that generalist nurses should also adopt this attitude to promote the establishment of home stoma care for older patients, with CNs and generalist nurses working toward the same goal.

Objective: This study investigated sleep quality of nurses working shifts in intensive care unit (ICU) and their other daily life activity times that are factors in synchronizing the circadian rhythm to better understand daily life activity times that may influence the night sleep quality (sleep efficiency: SE).

Methods: A survey was conducted with twenty-two ICU nurses on five-day daily life activities (holiday, day-time shift day, night shift day, day after a night shift, and holiday). The sleeping conditions of three nights during the five days were measured with Actiwatch^®. We divided the nurses into two groups by each night SE score (SE-good: SE ≥85.0%, SE-poor: SE <85.0%), and compared the daily life activity times for the two groups.

Results: The SE (median) of the participants in this study was above 85.0% for each night sleep. For the daily life activity times, the SE-good and SE-poor groups in the night sleep at day after a night shift showed differences in the time of first meal eaten after night shift (p = .017): the SE-good group tends to eat in the morning and the SE-poor in the afternoon.

Conclusions: Nurses working shifts in ICU largely maintained an SE above 85%. Further, the findings suggest that the time of eating meals, which corresponds to breakfast after a night shift, may influence the SE on the day after a night shift.

Aim: The present study aims to examine the association between frequency or confidence of information and communication technology (ICT) devices utilization and self-efficacy of neighborhood watch or frequency of home visits for older adults among local volunteers (LVs).

Methods: A total of 927 LVs living in two municipalities were studied using self-reported anonymous surveys. The frequency and confidence of ICT usage, self-efficacy of neighborhood watch, and frequency of home visits for older adults among LVs were measured. Two multivariate logistic regression analyses adjusted for sociodemographic characteristics were conducted, investigating frequency or confidence of ICT usage as the independent variables and self-efficacy of neighborhood watch or frequency of home visits for older adults as dependent variables.

Results: Among 451 LVs (aged ≥65 years: 76.0% of the total participants, with females comprising 67.6%), 11.3% persons had basic phones, while 33.9% possessed smart phones. The rate of persons having more than one ICT device was 54.8%. High levels of confidence of ICT device usage significantly associated with the self-efficacy of neighborhood watch for older adults among LVs (odds ratio = 1.57, 95% confidence interval = 1.04–2.38, p-value = .03).

Conclusion: The results suggest that confidence in usage of ICT devices could positively associated with self-efficacy of neighborhood watch for older adults, among LVs.

Objective: To develop the scale to measure the information and communication technology (ICT) skills of home visiting nurses and to examine the developed scale’s reliability and validity.

Method: We mailed a survey to managers at 1,000 visiting nurse stations in May 2022 and analyzed the responses of 156 nurses. The survey included questions on individual characteristics and the status of the use of ICT devices in and 22 ICT skills related to visiting nurse services.

Results: We extracted three factors, namely, Factor 1 [Skills for appropriately storing and sending medical information], Factor 2 [Skills related to organizational security], and Factor 3 [Skills related to the setting of a valid password and its protection], and 14 items. The Cronbach’s alpha coefficient for the entire scale was 0.91 and for Factors 1, 2, and 3 was 0.88, 0.79, and 0.76, respectively. GFI was 0.91, AGFI was 0.83, CFI was 0.88, RMSEA was 0.09, and SRMR was 0.06.

Conclusion: We confirmed that the scale’s reliability and validity were acceptable.

Purpose: This study aimed to clarify home-visit nursing practice toward using child development support or day care for technology-dependent children.

Methods: A semi-structured interview was conducted with 10 experienced pediatric home-visit nurses, and an analysis was performed with reference to the content analysis method of Berelson (1952/1957).

Results: Home-visit nursing practice toward using child development support or day care for technology-dependent children was formed from fifteen core categories such as (a) considering a child’s school attendance and mother’s social participation, and suggesting the use of child development support or day care without missing an opportunity, (b) suggesting and adjusting visits to consider suitable child development support or day care according to the parents’ wishes, and encouraging communication with concerned parties, and (c) preparing the children and their families for and adjusting home-visit nursing days to adapt to the changes in life associated with using child development support or day care.

Conclusion: For nursing technology-dependent children needing child development support or day care, it is necessary to raise parents’ interest in using it, while considering the future of their children. In addition, they need support in their decision-making regarding using it, the application procedures, and preparing in collaboration with multi-professionals based on the prediction of the impact of the use.

Purpose: The purpose of this study was to describe the meaning of nurses’ experiences in practical training from their narratives looking back on their training.

Methods: A phenomenological research method was used. Unstructured interviews were conducted individually and in groups of six participants over 9 months. In this paper, I report the stories of two people who talked about the changes during their 4 years of practical training. My focus was the meaning brought by the practical training experience from a long-term perspective.

Results: Participant B learned step-by-step through her practical training and understood that her relationship with patients had changed. Participant C said that her nursing practices were reflected to her practical training experiences, which did not go well.

Conclusions: The nurses’ relationships with patients and failed practice experiences changed their perspectives on nursing and their attitudes as nurses. The practical experience formed the basis of the participants’ attitudes and practices when they became nurses.

Aim: This study examined the influence of proactive behaviors in organizational socialization of new graduate nurses on their state of workplace adaptation.

Methods: A questionnaire survey was conducted with 1,349 new graduate nurses using the Scale of Proactive Behaviors in the Organizational Socialization of New Graduate Nurses and the Workplace Adaptation State Scale. As it was hypothesized that proactive behaviors in organizational socialization would influence the nurses’ state of workplace adaptation, multi-indicator models were created, and covariance structural analysis was performed.

Results: The study analyzed 272 valid responses. The model’s goodness of fit was GFI = .963, AGFI = .922, CFI = .965, and RMSEA = .074. All path coefficients were significant at the .1% level, with a path coefficient from [proactive behaviors] to [the state of workplace adaptation] of .77 and a coefficient of determination of .59.

Conclusion: Proactive behaviors in the organizational socialization of new graduate nurses influenced their state of workplace adaptation. The results suggest the importance of not only encouragement from organizations but also the proactive behaviors of graduate nurses in workplace adaptation.

Objective: To develop a work environment measurement scale for visiting nurses.

Methods: An Internet survey or a mailed questionnaire survey about the scale was distributed to 2,500 visiting nurses nationwide, and the reliability and validity of the scale were examined.

Results: Responses were obtained from 276 respondents (response rate: 11.4%) and were included in the analysis. From the analysis results, 35 items from 5 factors (flexibility and adequacy of resources, leadership of managers, educational and career support for nursing quality, multidisciplinary collaboration, and support system for nursing practice) were extracted. The model fit was GFI = 0.811, AGFI = 0.779, CFI = 0.901, and RMSEA = 0.058. Correlation coefficients with external criteria ranged from –0.512 to 0.677. The Cronbach’s alpha coefficient for the overall scale was 0.95, and the intraclass correlation coefficient was greater than 0.8 using the retest method.

Conclusion: Although the model fit was slightly below the criterion (e.g., GFI <0.9), the scale was confirmed to have a certain degree of reliability and validity. The work environment measurement scale can be used as an indicator for visiting nurses to evaluate good work environments.

Purpose: This study aimed to examine the reliability and validity of a self-assessment scale for nurses to enhance dialogue support between terminally ill cancer patients and their families.

Methods: Subjects were 1,196 nurses with at least 3 years of clinical experience working at hospitals throughout Japan, and who were involved in the care of terminally ill cancer patients. An online questionnaire was administered, which included 38 items on a self-assessment scale for nurses’ support of dialogue between terminally ill cancer patients and their families. The statistical analysis included exploratory factor analysis, and examination of internal consistency and construct validity.

Results: A total of 370 responses (30.9%) were analyzed. An exploratory factor analysis helped identify four factors (22 items): (1)Assessing patients’ and families’ dialogue needs; (2)Focusing on patients and families for a deeper understanding of them; (3)Engaging with patients and families with respect for each other’s feeling; and (4) Utilizing a team approach for dialogue support. Cronbach’s alpha coefficient was .944 for the total scale and ranged from .797 to .908 for the four factors. The goodness of fit of the model was as follows: GFI = .888, AGFI = .860, CFI = .931, and RMSEA = .063. The known-groups technique was used to examine construct validity. The scale score showed significantly higher scores among groups with experience in a palliative care unit and among certified nurses or certified nurse specialists in oncology nursing. The convergent validity was .819 (p < .01), concurrent validity was .403 (p < .01).

Conclusions: This study’s results suggest that the scale’s validity and reliability were within the permissible range.

Purpose: This study is aimed at describing midwifery care provided for women with cancer diagnosed in pregnancy and their families.

Methods: Unstructured interviews were conducted with seven midwives who had experience of assisting women diagnosed with cancer. The data was analyzed using the narrative approach.

Results: Concerning 15 episodes, we found subthemes, based on which one theme per one episode was identified. Having analyzed the episodes, subthemes, and the themes in a cross sectional manner, we clarified that there are four themes that represent midwifery care: Supporting women so they can make the best decision based on a wide range of information that provides a balanced perspective, when debating with themselves whether or not to continue a pregnancy, to undergo cancer treatment, or to breastfeed; perceiving the women as mothers who would or would not undergo cancer treatment during their pregnancy; understanding their thoughts during the continuous span of cancer treatment, pregnancy, delivery to as far as the period of childcare and dealing with the women and their families considering the impact on the whole family; and taking care of the women and their families, while working with multiple departments and professions and going in the same direction.

Conclusion: Midwives’ practice was characterized by viewing women as mothers, based on the midwifery care values of maternal and newborn care. Their perspective and practice of having regard for women as mothers is important to further support the women and families through enhanced collaboration and cooperation among multiple departments and professions.

Objective: To clarify which factors including couple relationship (marital and coparenting relationship) affect depressive symptoms in parents who are caring for their preschooler aged 2 to 4 years when childcare-related burdens are changing as the child grows.

Methods: This observational study included 136 men and 121 women who were taking care of their child aged 2 to 4 years. The dependent variable was depressive symptoms assessed by the Center for Epidemiologic Studies Depression Scale (CES-D), and the independent variables were couple relationship assessed by the Coparenting Relationship Scale (CRS) and the Quality of Marriage Index (QMI). Multiple regression analysis was conducted separately for men and women, respectively.

Results: CES-D in men was associated with CRS (β = –.454, p < .001), and CES-D in women was associated with CRS (β = –.329, p = .002) and QMI (β = –.255, p = .015).

Conclusion: Better score of coparenting relationship was associated with low CES-D score in both men and women caring for their child aged 2 to 4 years.

Objective: This study aimed to reveal the association between work engagement (WE) and autonomy among nurses certified as gastroenterological endoscopy technicians.

Methods: We conducted cross-sectional online survey among 1,000 nurses certified as gastroenterological endoscopy technicians. The survey items included personal attributes, job demands, job resources, endoscopy nursing characteristics, the Japanese version of the shortened version of the Utrecht Work Engagement Scale (UWES), and autonomy (professional autonomy scale for nurses).

Results: A total of 337 subjects (response rate of 33.7%) were included in the analysis. A multivariate logistic regression analysis, dividing WE into high and low groups and using personal attributes and job resources as independent variables, revealed that autonomy was statistically significantly associated with the high level of WE (odds ratio = 1.04, 95% confidence interval: 1.02–1.05, p < 0.001). There was an interaction where WE increased when the degree of autonomy was high and involvement with patients was sufficient (F,(1, 257) = 6.3, p = 0.013).

Conclusion: The results showed that there is a strong association between WE and autonomy among nurses certified as gastroenterological endoscopy technicians. Furthermore, a high degree of autonomy and sufficient involvement with patients were suggested to be influential in further increasing WE.

Purpose: This study aimed to use chaos analysis to extract the pulse wave characteristics on the effects of mindful breathing exercises, mainly meditation, in nursing students.

Methods: Twenty nursing students (aged, 21–22 years) were randomly assigned to either the mindful group (Mi group, n = 10) or the non-mindful group (nMi group, n = 10). The experiment was carried out for 10 days, and pulse waves were measured on days 1, 5, and 10. The attractors calculated from the pulse wave were visually evaluated, and the maximum Lyapunov exponents while resting with the eyes closed and during a mental arithmetic task were compared between the groups. The maximum Lyapunov exponent increased with sympathetic nervous system activation.

Results: The shape of the attractor on day 10 of the experiment exhibited little variation in the Mi group, whereas the nMi group had more complex changes. The maximum Lyapunov exponent of the Mi group stayed at ≤1.7, which was significantly lower than that of the nMi group.

Conclusion: This suggests that inhibition of the sympathetic nervous system occurred after mindful practice in the Mi group on day 10 of the experiment. Signal processing using chaos analysis could be used to evaluate the characteristics of mindful breathing techniques.

Objective: The aim of this study is to clarify the preferred place of death and related factors when dementia occurs, targeting the bereaved families of dementia patients and medical professionals.

Methods: Cross-sectional internet survey was conducted in October 2019. The subjects were the bereaved family (n = 618), doctors (n = 198), nurses (n = 197), and care workers (n = 193).

Results: The preferred place of death for the bereaved families were homes (33%), hospitals (31%), and care facilities (32%). In addition, the proportion of medical professionals at home tended to be 41%–51% higher than that of bereaved families. The desired place of death of the bereaved family was related to the deceased’s place of death (Nursing care home; OR = 2.80, P < .001, Home; OR = 1.58, P = .05).

Conclusion: The bereaved families who took care of dementia patients experienced good care at home and nursing homes. It was suggested that the desired place of the bereaved family may be related to the image obtained through the experience of the bereaved family.

Purpose: To focus on the physical restraints encountered by nursing students in their clinical practice and to identify from their experiences their edits of how nursing students consider and act on the questions that arise from these restraints.

Methods: A qualitative descriptive study was conducted using narrative analysis. Based on the kinship method, the study sample consisted of 16 prospective graduates who were about to graduate from the Bachelor of Science in Nursing program in March 2021. Semi-structured interviews were conducted online using an interview guide. Thematic content analysis was performed to analyze the interview data.

Results: In total, 251 question-editing narratives were extracted from 16 cases, typified by 12 question-editing themes and 32 sub-themes.

Conclusion: In the context of ethics, the analysis results showed a tendency toward polarized thinking in the nursing students, suggesting the need for the involvement of faculty, clinical practice supervisors, and others in “expanding the possibilities of thinking,” which is necessary for ethics education.

Objectives: In this study, we investigated the current state of discharge support provided by nurses in a rehabilitation wards and the factors affecting it.

Methods: A questionnaire survey was administered to 1,937 nurses working at rehabilitation wards. The participants were questioned about their prior nursing experience, participation in training, and cooperation with other departments. Additionally, nurses were questioned on the current state of discharge support (8 elements, 36 items). Data were analyzed using stepwise multiple regression.

Results: In total, 920 nurses were responded, of which 903 were analyzed. The mean length of nursing experience of the participants was 15.7 years. The best current state of discharge support was “cooperating with in-hospital staff (such as social workers or physical therapists).” Factors that significantly influenced discharge support included years of experience in rehabilitation wards (B = .693, p < .001), perceived importance (B = .397, p < .001), cooperation with other departments (B = 1.186, p = .000), and years of experience in cerebrovascular disease wards (B = .244, p = .022).

Conclusion: In conclusion, nurses cooperate with various professional staff to provide discharge assistance. It was hypothesized that the provision of discharge support by nurses was affected by their awareness of its importance, experience in convalescent and cerebrovascular disease wards, and cooperation with various staff.

Purpose: To clarify how pediatric nurses recognize the protection of children’s rights during medical examinations and procedures and how they practice nursing for the protection of children’s rights.

Methods: A semi-structured interview was conducted with 20 nurses with five years of experience regarding the practice of protecting children’s rights. Data were analyzed using the grounded theory approach.

Results: The nurses “assessed whether the child was able to undergo the procedure”, and “encouraged care that the child would be comfortable with.” The nurses tried to “reduce the child’s fear” and “wait for the child’s wavering feelings of doing their best,” which led to “involvement that was able to protect the child’s rights.” In some cases, in which the nurses were not able to protect the child’s rights, depending on how the nurses view the situation.

Conclusion: During nursing care, the nurses view the child and the situation from various perspectives and adjust to the environment; they respect the child’s independence while also pursuing their best interests and adjusting to the situation.

Purpose: To identify obstructive and continuation factors at work in working caregivers.

Methods: Semi-structured interview was conducted to working caregivers who were taking care of their elderly closest family members. We assessed obstructive and continuation factors at work from the interview.

Results: We performed a qualitative and inductive analysis from 9 principal caregivers, and 15 categories were identified as obstructive factors at work, which include [time-consuming caregiving]; [difficult time allocation for work against increased demand of caregiving]; [feeling guilty about caregiving to colleagues at workplace]; [anxiety about life and health of caregivers themselves]; and [shortage of required information on caregiving]. For continuation factors, 8 categories were identified including [understanding of caregiving and support from family and colleagues]; and [working place environment supportive to both work and caregiving].

Conclusion: Results suggest that working caregivers should not wish perfect caregiving but maintain healthy condition for continuation of caregiving. Supports from family members and colleagues at workplace, and use of public services for caregiving are important to avoid isolation of working caregivers.

Purpose: This study determines the influence of paternal image formation in coparenting among couples raising children under three years of age in Japan, during the period from pregnancy to immediate postpartum.

Method: A total of 1,621 subjects were studied. Three multiple regression models were created using items that past research has found to be related to coparenting.

A Scale of Father identity in the Transition Period and factors predicted to influence coparenting were set as independent variables, while the Coparenting Relationship Scale Japanese version (CRS-J) was set as the dependent variable in the multiple regression model.

Results: Significant regression was found in all models (p < .01). However, significant associations with CRS-J scores were found only for the scores of “a rush of emotion coming from the existence of a child/children,” “the upwelling consciousness of being a father” and “concerns for the wife”.

Conclusion: The results suggest that differences in paternal image formation that arise during pregnancy may impact coparenting during infancy. Among the independent variables, “concerns for the wife” had the highest influence, suggesting that a good marital relationship is an important factor affecting coparenting.

Purpose: The use of with Bacillus cereus (B. cereus)-contaminated towels for bed baths can cause bloodstream infections in immunocompromised patients. This study aimed to assess the extent of B. cereus adhesion and growth on towels wiped on forearms.

Methods: We recruited 50 healthy subjects aged 20–68 years between August and October 2021. Both forearms of each participant were wiped with clean warm towels. The number of B. cereus colonies were immediately determined after wiping for the right-arm towels and after storing the towels at room temperature (24–26°C) for 24 hours, for the left-arm towels. The relationship between the number of B. cereus colonies and attributes was analyzed.

Results: Seven (14.0%) and 37 towels (74.0%) were found to contain B. cereus immediately after wiping and following 24-hour storage, respectively. On average, the B. cereus count was 6,000 times higher after 24-hour storage than immediately after wiping. Individuals who applied moisturizer had a higher number of B. cereus colonies on towels immediately after wiping compared to those who did not (p < 0.05). In towels stored for 24 hours after wiping, individuals who had not undergone arm hair removal had a higher number of B. cereus colonies compared to those who had (p < 0.05).

Conclusion: Despite individual differences, B. cereus can adhere to human forearms. Storage of towels at room temperature after wiping leads to bacterial growth and increased possibility of B. cereus spore formation; therefore, suppression of bacterial growth on used towels is necessary.

Purpose: To clarify the process through which skilled nurses continue providing support for the changed feelings in patients with spinal cord injuries in the recovery period.

Methods: Semi-structured interviews were conducted with 14 skilled nurses to investigate their “experience with providing support for the changed feelings of patients with spinal cord injuries.” Thereafter, these interviews were analyzed using M-GTA.

Results: To address the anxiety and fear of patients transferred to the rehabilitation ward, skilled nurses collaborated with multiple professionals to provide “support for receiving secure medical care,” “support for increasing awareness and amplification of buried self-resources,” “support for alleviating expressed anger and internal discouragement,” “support for motivation to acquire new excretion techniques” and “support for stabilization of fluctuating will.” These services are intended to “help patients reconceptualize their individuality.” In addition, for patients who questioned their existence because of becoming a nuisance to their families, the nurses provided “support to free them from negative perceptions regarding the meaning of their existence.”

Conclusion: To support the changing feelings of patients, it is necessary for nurses to combine and fine-tune their support from time to time, and to continue providing support in cooperation with multiple professionals.

Purpose: The study aimed to explore pain with colonoscopy experienced by patients with inflammatory bowel disease.

Methods: We conducted semi-structured interviews with 10 patients with inflammatory bowel disease who were in remission and analyzed the data qualitatively and descriptively.

Results: Participants experienced pain with colonoscopy such as “physical and mental burden with the bowel preparation,” “pain during colonoscopy,” “fear of colonoscopy,” “a feeling of resistance to healthcare professionals of the opposite sex,” “fatigue and disease aggravation after colonoscopy,” “anxiety about investigation results,” and “burden of time and cost.” “Pain during colonoscopy” included ‘pain accompanying the colonoscopy procedure when the inflammation was active,’ ‘pain due to complications of inflammatory bowel disease when inserting the colonoscope or changing body position,’ ‘pain when the tip of the colonoscope was in the colic flexure,’ and ‘abdominal tension and pain from insufflated air.’

Conclusion: Patients with inflammatory bowel disease experienced disease-specific pain with colonoscopy owing to intestinal inflammation and complications of the disease.

Purpose: This study clarifies the care experience specific to a mixed obstetrics ward as perceived by midwives working there. Furthermore, it identifies the care capabilities drawn from that experience.

Method: Eight midwives with more than four to five years of experience in a mixed obstetrics ward were interviewed using a semi-structured interview and the responses were analyzed qualitatively and descriptively.

Results: Midwives recognized that their experience of care unique to mixed maternity wards and their own care ability were [Accurate judgment and adjustment ability in the field of obstetrics based on the experience of working as a single midwife who feels a heavy responsibility], [Assessment and adjustment ability of subjects with a broad perspective based on experience in caring for patients from other departments], [The ability to think about post-discharge life and childcare from a long-term perspective based on the experience of touching the lives of patients from other departments], [The ability to utilize the midwife’s expertise in care within the nursing team based on working with nurses].

Conclusions: The experience of care unique to mixed obstetrics wards, such as the working system of one midwife and care for patients from other departments, suggests the need to consider the educational system so as to cultivate the necessary care skills as a midwife.

Objective: To clarify the decision-making support process of visiting nurses to help terminal cancer survivors “live a fulfilling life”.

Methods: Semi-structured interviews were conducted with 17 nurses, who had worked as a visiting nurse for 3 years or longer and had experience in providing home care and end-of-life care for patients with terminal care needs. We analyzed the data using the modified grounded theory approach.

Results: The decision-making support process was focused on <facing life together>, including <realizing the ordinary and extraordinary aspects of daily life>, <going alone with patients who are still attached to cancer treatment>, and <helping patients prepare for the end of life>. These approaches were facilitated by <promoting realistic decisions> and <focusing on symptom relief>, and based on <establishing a nurse-led system>.

Conclusion: The decision-making support process helps terminal cancer survivors maintain hope, even if it is only a little, and “live a fulfilling life” by actively designing the rest of their lives, and achieving a “good death”.

Objective: The purpose of this study was to reveal how expert nurses involved in recuperative assistance for patients with chronic respiratory disease support ACP during the transitional period.

Method: Semi-structured interviews were conducted with expert nurses who assisted patients with chronic respiratory disease. The interviews were analyzed qualitatively and inductively.

Results: By “listening particularly to their everyday life while building a relationship of trust,” they built an uninterrupted relationship. This led to support for “creating a foundation for patients and their families to choose.” Moreover, in order to be able to “know the timing of ACP intervention,” nurses “assessed the changing situation and provided support.” They built a supportive environment that allowed the “building of trust as a team and making progress.”

Conclusion: In the trajectory of going back and forth from a stable to an unstable period, continuous assistance was provided to support patients as a team, so that they could make choices and decisions based on their lifestyle background and values.

Purpose: The purpose of this study was to clarify psychiatric nurses’ involvement with to patients who they had met for the first time and who were in a restless state when admitted to a psychiatric hospital at the time of admission.

Methods: This is an exploratory and qualitative study using a modified grounded theory approach in which semi-structured interviews were conducted with 12 psychiatric nurses.

Results: Nurses’ involvement to hospitalized psychiatric patients exhibiting restlessness were as follows: They used a [non-threatening approach] and were part of a process of [helping patients realize they were their allies] while [imagining the world experienced by patients]. In addition, the process was supported by [self-management to remain an ally] and was based on nurses’ beliefs of [trying to understand one another].

Conclusion: Psychiatric nurses believe that they have the sensitivity to communicate with patients, and the results suggest that it is important for nurses to continue sending the message that they are on the patients’ side starting at the time of hospitalization.

Purpose: This study aims to clarify the actual situation of hearing loss care for older adults by visiting nurses.

Method: We conducted an online survey of knowledge, assessment, care, multidisciplinary collaboration, difficulties, and learning needs with 1,361 visiting nurses to understand hearing loss care’s actual situation.

Results: On knowledge of hearing loss care, the percentage of visiting nurses who were uninformed ranged from 60 to 90% across all items. Furthermore, results for assessment and care were low overall. The percentage of visiting nurses who did not perform assessment and care ranged from 50 to 100% and 40 to 100% across all assessment items and all but one care item, respectively. Additionally, the percentage of visiting nurses who did not practice multidisciplinary collaboration ranged from 60 to 90% across all items. Finally, many visiting nurses experienced difficulties when conducting assessments of hearing loss severity (approximately 80%) and earwax removal (approximately 70%). More than 90% of visiting nurses felt that “learning needs” related to hearing loss care were necessary.

Conclusion: While the knowledge and implementation rate of visiting nurses required for hearing loss care were low, learning needs for hearing-impaired care were high. These results suggest the need for hearing loss care education for visiting nurses in the future.

Aim: This study reviewed the relevant literature with the aim of synthesizing the structure of internal and external negotiations in terms of the ongoing multi-level loss of control for patients with amyotrophic lateral sclerosis.

Methods: This study was carried out using a method of meta-synthesis. Eleven original articles in Japanese and two original article in English were utilized. Perceptual Control Theory provided a coding framework.

Results: From 99 systems, three themes characterized the internal and external negotiations of patients with amyotrophic lateral sclerosis: “Identify the threat,” “Refuse, withdraw, expect self,” and “Travel the ALS survivor world”.

Conclusions: This review adds knowledge to our understanding of the structure of multi-level loss of control for patients with amyotrophic lateral sclerosis, suggested that it is necessary for these patients to continue external negotiations to maintain a sense of control. Future research should focus on the integrative interpretation of internal and external negotiations in amyotrophic lateral sclerosis patients who are attempting to maintain a sense of control.

Aim: This study identified the difficulties in daily life faced by families of older adults with dementia during a disaster and through the mid- and long-term aftermath of the disaster.

Methods: Semi-structured interviews were conducted with five individuals who were living at home with an older adult relative with dementia when they were affected by the Kumamoto earthquake in 2016 or by the torrential rainfall of July 2018. Riessman’s thematic analysis was used to examine the data.

Results: Four core themes emerged from the 12 themes, including: ‘the anguish of caring for the relative with dementia, maintaining one’s own health and rebuilding one’s life after the disaster’ and ‘the impossibility of having to bear everything alone with patience and discretion during the evacuation’. Postdisaster life was made more difficult for the participants because the older adults with dementia had to be cared for first, and the participants had to rebuild their lives by themselves.

Conclusion: Professionals and non-professionals caring for older adults with dementia and their families may reduce the families’ hardship by taking measures to support them after disasters, providing information, and encouraging the use of informal and formal support services.

Purpose: To clarify the factors that influence recovery-oriented practice for inpatients as recognized by the nursing directors of psychiatric hospitals.

Methods: A semi-structured interview survey was conducted to 20 nursing directors of psychiatric hospitals in Japan. The interview data were transcribed verbatim, and qualitative descriptive analysis was performed with reference to the data analysis method of Graneheim.

Results: In terms of the factors influencing the practices facilitating the recovery of inpatients recognized by the nursing directors, 325 codes were extracted and classified into 21 categories and four core categories: nursing director’s recovery-orientation and communication to the staff, existence of colleagues who approve the idea of the nursing director, sense of professional fulfillment during discharge support, and culture and climate of the hospital organization.

Conclusion: The following points were suggested for the introduction of practices facilitating recovery in psychiatric hospitals in the future. There is a need for education that enhances recovery-oriented attitudes of nursing directors, education on patient recovery for the hospital as a whole, including multiple occupations and other departments, and a need for seeing and listening to patients’ experience of the recovery process, including understanding of the patients’ lives after hospital discharge.

Aim: To clarify the structure of branch public health nurse’s activities in depopulated areas in widely merged municipalities.

Methods: Semi-structured interviews were conducted with eight public health nurses who had experience in working as branch public health nurses in depopulated areas in a broadly merged municipality, and the results were analyzed using the qualitative synthesis method (KJ method).

Results: The cooperation in the activities of public health nurses at branch offices included both “extensive coalition-building,” which included even residents, and “sustainable coalition-building,” which was systematized, and formed a good cycle in both directions by adding “Progress towards new regional development.” In addition, the “Carrying out branch office work that requires competence building” is the foundation for “District responsibilities in branch office work,” which is responsible for overall health and welfare work, and “Project development based on regional characteristics” according to district diagnosis and PDCA cycle.

Conclusion: The structure of the activities of branch office public health nurses in depopulated areas were clarified. It was suggested that the “Carrying out branch office work that requires competence building” is the foundation of all activities, under the long-term overarching guidance and the authorized consultation system by those who have worked at branch offices. The findings of this study will contribute to identifying the direction of human resource development of public health nurse in the future.

Objective: The purpose of this study to identify the factors that affect life satisfaction levels in older adult individuals who are the primary caregivers for elderly family members.

Method: We visited and interviewed a total of 92 study participants consisting of home nursing recipients aged ≥65 years and their primary caregivers of at least 6 months who were also aged ≥65 years. Our survey contained questions on the participant’s age, sex, duration of care, life satisfaction (LSI-K), perceived care burden (J-ZBI), mental health status (CES-D8), and sense of coherence (SOC; SOC13-5). We then performed multiple logistic regression analysis on the survey caregivers’ life satisfaction as the dependent variable.

Results and Discussion: The results of our analysis indicated that the primary caregivers with a high level of life satisfaction (LSI-K) had a higher SOC (SOC13-5) and lower perceived care burden (J-ZBI) than those with low life satisfaction (LSI-K), and that duration of care, perceived care burden (J-ZBI) and SOC (SOC13-5) were all involved in this outcome. That is, the higher levels of life satisfaction (LSI-K) seen in some of the primary caregivers in this study could be attributed to a high SOC (SOC13-5) that allowed them to properly cope with care-related stress, thereby reducing their perceived care burden (J-ZBI).

Conclusion: Our study findings suggest that duration of care, perceived care burden (J-ZBI) and SOC (SOC13-5) are all important factors that affect the life satisfaction (LSI-K) of older adult primary caregivers.

Objective: To develop the “Evaluation scale for Pathophysiology Teaching Activities in Nursing Clinical Practicum” (EPTA-NCP) for nursing faculty and to test its reliability and validity.

Methods: A draft of 37 scale items was created based on the results of a qualitative study. A questionnaire survey was conducted on faculty members in their second year or more of teaching in the nursing specialty areas of adult nursing and gerontological nursing at nursing colleges, which was examined for construct validity, internal consistency, and criterion-related validity. The Test-retest method was used to verify the reproducibility of the scale.

Results: 385 valid responses (response rate 47.4%) were subject to analysis. Exploratory factor analysis yielded a 6 factor-structure with 23 items, while a confirmatory factor analysis yielded model fit indices of GFI = .899, AGFI = .858, CFI = .924, and RMSEA = .063. A significant correlation with external criteria was observed, with Cronbach’s alpha coefficient for the overall scale at .911. Furthermore, in the Test-retest method, data from 80 valid responses (response rate 39.0%) were analyzed, and the correlation among scores was .911 for the overall scale.

Conclusion: The reliability and validity of this scale were found to be generally ensured.

Aim: We identified a hope-mediated work engagement (“WE”) process model in male nurses.

Methods: An explanatory design using mixed methods research was used. A web-based survey was administered to 839 male nurses, and a process model of WE was tested using structural equation modeling. Thereafter, semi-structured interviews were conducted with 13 consenting participants, and the content was integrated with quantitative results.

Results: Responses of 228 participants were included in the analysis (valid response rate 27.2%). As a process model of WE, supervisor consideration, nursing-related qualifications, and support for higher education mediated hope and influenced WE (GFI = .951, AGFI = .906, RMSEA = .084). Participants were aware of their male role, and the association between supervisor consideration and hope was explained by “career advancement in a more supportive organization,” etc.

Conclusion: In the process of clarifying hope-mediated WE process model among male nurses using a mixed method research, male nurses were found to be gender-aware; however, they were also aware of balancing work and family life.

Purpose: To evaluate the effectiveness and usefulness of a training program for postpartum depression using an instructional design.

Method: Using the theory of instructional design (ID) as a framework, a training program on postpartum depression for public health nurses was developed and implemented using e-learning. For the knowledge test and goal attainment scores, before training, immediately after training, and one month after training scores were calculated, and Friedman tests were performed. Multiple comparisons were performed for each time period using Bonferroni’s method.

Results: The study included 40 public health nurses. The training content was highly responsive to interest and concerns. The participants significantly improved their knowledge test and goal achievement immediately after the training and one month after the training,compared to before the training (p < .05); and they applied the knowledge and skills gained from this training to their practical activities.

Conclusion: This training program motivated the subjects to learn, and led to the acquisition of knowledge and improvement of practical ability. The results suggest that it would be useful to incorporate the ID method into future education and training programs for health workers.

Objective: To conduct serial measurement of subjective and objective sleep indices in pregnant women to determine the relationship between autonomic nervous system activity and sleep disturbances over the course of pregnancy.

Method: Subjective sleep indices (Pittsburgh Sleep Quality Index [PSQI-J], Epworth Sleepiness Scale [JESS]), objective sleep indices, and autonomic nervous activity were measured in pregnant women using a Silmee Bar type Lite biosensor in each of early, middle, and late pregnancy. Overnight mean values of high-frequency (HF) as a measure of parasympathetic activity and overnight mean values of low-frequency (LF)/HF ratio as a measure of sympathetic activity were used in the analysis.

Results: Thirty-seven patients were included in the analysis. PSQI-J scores were significantly lower in the middle period than in the early periods. Regarding autonomic activity, mean HF was significantly higher in the early period and mean LF/mean HF was significantly lower in the early period. In the late period, positive correlations were found between PSQI-J score and mean LF/mean HF, as well as between JESS score and mean LF/mean HF, and negative correlations were found between PSQI-J score and mean HF, as well as between JESS score and mean HF.

Conclusion: The present findings suggest that autonomic nervous system activity may be a contributing factor to sleep disturbances in pregnant women.